If you or someone you know is in crisis right now: call or text 988 (Suicide & Crisis Lifeline). For a possible overdose or any medical emergency, call 911. For help finding treatment, the SAMHSA National Helpline is free and open 24/7 at 1-800-662-4357.
The short answer
Medication-assisted treatment (MAT) uses FDA-approved medications, together with counseling and support, to treat substance use disorders. It is most established for opioid, alcohol and tobacco use disorders. These medications reduce cravings and withdrawal, lower the risk of relapse and, for opioids, reduce the risk of overdose death. Many professionals now say medications for opioid use disorder (MOUD) or medications for addiction treatment (MAT) to emphasize that medication is treatment, not an add-on.
What is medication-assisted treatment?
MAT combines medication with behavioral therapy. The medication addresses the biological side of the disorder, such as cravings and withdrawal, while therapy and support address habits, triggers and daily life.
It is not a shortcut or a replacement for effort. It is one of the best-supported treatments available for certain disorders. (For how therapy fits in, see [Evidence-Based Therapies in Addiction Treatment: CBT, DBT and Contingency Management].)
Is MAT just “replacing one drug with another”?
No, and this is the most common myth. Physical dependence and addiction are different things. (See [Addiction vs Dependence vs Tolerance: What’s the Difference?].) Medications used in MAT are prescribed at stable doses under medical supervision, and they allow people to stop the cycle of intoxication, withdrawal and cravings. People on these medications can work, parent, study and rebuild their lives.
Medications for opioid use disorder
| Medication | How it works | What to know |
|---|---|---|
| Buprenorphine | Partially activates opioid receptors, easing cravings and withdrawal with a lower overdose risk | Prescribed in a doctor’s office, clinic or by telehealth. Since 2023, clinicians no longer need a special waiver to prescribe it. |
| Methadone | Fully activates opioid receptors, easing cravings and withdrawal | Dispensed through certified opioid treatment programs, with a gradual path toward take-home doses |
| Naltrexone (extended-release injection) | Blocks opioid receptors so opioids have no effect | Not an opioid. You usually need to be opioid-free for a period before starting, which a clinician will explain. |
The right choice depends on your history, health, preferences and access. Research shows that buprenorphine and methadone are associated with lower overdose risk and better staying power in treatment. (See [Opioid Addiction Treatment: Buprenorphine, Methadone and Naltrexone Compared].)
Medications for alcohol use disorder
- Naltrexone reduces cravings and the reward of drinking.
- Acamprosate helps the brain adjust after stopping and eases lingering discomfort.
- Disulfiram causes an unpleasant reaction if you drink and works best with strong support.
- Some other medications are sometimes used off-label, at a doctor’s discretion.
Only a minority of people who could benefit from medication for alcohol use disorder receive it, so it is worth asking about. (See [Alcohol Use Disorder Treatment Options: From Detox to Medication].)
Medications for tobacco use disorder
Nicotine replacement therapy, varenicline and bupropion all improve the chances of quitting, especially combined with counseling. Tobacco is a substance use disorder too, and treatment is worth pursuing.
What about other substances?
For stimulants (cocaine, methamphetamine) and cannabis, there are currently no medications approved for the disorder itself, so treatment relies on behavioral approaches such as contingency management and CBT. Research on new medications is ongoing. For benzodiazepines, treatment typically involves a gradual taper under medical supervision. (See [Benzodiazepine Dependence: Why Tapering Should Be Medically Supervised].)
Who is MAT for?
MAT may be right for you if:
- You have an opioid, alcohol or tobacco use disorder
- You have relapsed after treatment without medication
- You struggle with strong cravings or withdrawal
- You are at risk of overdose
- You want a treatment with a strong research record
It is often recommended during pregnancy for opioid use disorder, because untreated disorder carries risks too. Talk to a doctor right away. (See [Addiction Treatment During Pregnancy: Safe Options and Legal Protections].)
How long does MAT last?
There is no one-size-fits-all timeline. Some people take medication for months, others for years, and some long term. Stopping should be a decision made with your doctor, once you are stable and have support, and not based on pressure from others. Stopping suddenly can raise the risk of relapse and overdose.
How MAT works in practice
- Assessment: a clinician reviews your substance use, health and goals.
- Choosing a medication together.
- Starting treatment, often with careful timing so withdrawal is managed.
- Ongoing visits to adjust the dose and monitor your health.
- Counseling and support alongside medication.
MAT can be offered in clinics, doctors’ offices, residential programs and through telehealth. (See [Is Telehealth Addiction Treatment Effective? Pros, Cons and Costs].)
Safety points
- Tell every doctor and pharmacist about all medications, including MAT.
- Avoid mixing with alcohol, sedatives or other opioids unless a doctor directs it.
- Keep naloxone at home if opioids are involved. (See [How to Get Naloxone (Narcan): Where to Find It Free and When to Use It].)
- Tolerance drops after a break from opioids, which raises overdose risk if use resumes.
- Report side effects to your doctor rather than stopping on your own.
Does a program support MAT?
Some programs do not offer or even allow medications. Ask:
- Do you offer or allow medications for opioid, alcohol and tobacco use disorders?
- Who prescribes and monitors them?
- Will I be able to continue my medication if I enter residential care or sober living?
Be cautious of programs that push you to stop prescribed medication or tell you it is “not real recovery.” (See [15 Questions to Ask a Rehab Center Before You Sign Up].)
Cost and access
Coverage varies by plan. Medicaid and many private insurers cover these medications, but rules differ by state and plan. Opioid treatment programs and community clinics often offer lower-cost options. (See [Does Insurance Cover Rehab? How to Check Your Benefits Step by Step] and [Free and Low-Cost Rehab Options Without Insurance].) You can search for providers at FindTreatment.gov or call the SAMHSA National Helpline.
If you are a family member
Support your loved one’s treatment plan, including medication, and avoid judgment about it. Learn how to use naloxone. (See [How to Talk to a Loved One About Addiction Without Pushing Them Away].)
Frequently asked questions
What is medication-assisted treatment?
Treatment that combines FDA-approved medication with counseling and support to treat substance use disorders, mainly opioid, alcohol and tobacco use disorders.
Is MAT just trading one addiction for another?
No. The medications are prescribed at stable doses under supervision and help people stop the cycle of cravings and withdrawal so they can rebuild their lives.
How long should someone stay on MAT?
It varies. Some people need medication for months, others for years. The decision to stop should be made with a doctor.
Can I get MAT through telehealth?
Often yes, for some medications such as buprenorphine, though rules and availability vary. Methadone is dispensed through certified programs.
Does MAT work?
Research shows that medications for opioid use disorder are associated with lower overdose risk and better retention in treatment. Medications for alcohol and tobacco use disorders also improve outcomes.
Can I use MAT in a rehab program?
Many programs support it, but some do not. Ask before you enroll.
Is MAT safe during pregnancy?
For opioid use disorder it is often recommended, with medical supervision. Talk to a doctor right away.
Sources
- SAMHSA. Medications for Substance Use Disorders. samhsa.gov
- National Institute on Drug Abuse (NIDA). Medications to Treat Opioid Use Disorder Research Report. nida.nih.gov
- National Institute on Alcohol Abuse and Alcoholism (NIAAA). Medications for Alcohol Use Disorder. niaaa.nih.gov
- American Society of Addiction Medicine. National Practice Guideline for the Treatment of Opioid Use Disorder. asam.org
This article is for general information only and is not medical advice. Talk to a qualified health professional about which treatment is right for you.